Many psychoanalysts thought of themselves as passive screens for their patients’ unconscious projections and hardly intervened in their free associations. If their analysands were silent, they advocated matching these silences; they joked among themselves that they had to smoke a lot to keep awake during such unproductive sessions. (One analyst who had awoken to find an empty couch justified his having dozed off by claiming that his unconscious was able to dutifully watch over his patient even as he slept.) Reich experimented with this passive technique, but it did not suit his energetic character—he had been attracted to analysis by Freud, who was, as Reich saw it, a dynamic conquistador of the psyche. When Reich put up a blank façade, as some advised, he found that his patients “only developed a profound helplessness, a bad conscience, and thus became stubborn.”27
Soon after he joined the staff at the Ambulatorium, Reich suggested to Freud the establishment of a technical seminar to explore alternative techniques. When the idea received Freud’s blessing, the first-ever teaching program for psychoanalysts was launched. The technical seminar, initially led by Reich’s superiors, Eduard Hitschmann and Hermann Nunberg (Reich took over in 1924), was aimed at less experienced analysts, but senior analysts regularly joined the debate. It took place in the Society of Heart Specialists’ windowless basement; the “long room with a long table and big heavy chairs,” according to Helen Ross, a trainee who had made the pilgrimage to Vienna from Chicago, was made even more claustrophobic by the fact that it was clouded in cigar smoke.28 The seminar propelled Reich to the center of the theoretical debates then taking place within the profession. In this concentrated, heavy atmosphere, the analysts presented the stories of their therapeutic struggles (Reich offered his foundering case of the impotent waiter) and thrashed out possible solutions in the hope of forging a new, clinically grounded psychoanalytic technique.
When Freud had introduced the idea of free clinics, in Budapest in 1918, he had also spoken optimistically about “a new field of analytic technique” that was “still in the course of being evolved.”29 In the early 1920s there were two main areas of innovation to which Freud might have been referring: Ernest Jones and Karl Abraham were pioneering “character theory,” and Otto Rank and the Hungarian analyst Sándor Ferenczi (who made sure to attend the technical seminar when he was in Vienna) were pursuing what they called “active therapy.” Reich would ultimately try to fuse these two strands, but the former played a greater role in the birth of his theory of the function of the orgasm.
Freud supposed that a child went through a series of developmental stages during which the infantile libido was concentrated on the mouth (the oral stage), then the anus (the anal stage), and the genitals (the phallic stage)—these phases were normally surmounted in weaning, toilet training, and the developing of the Oedipus complex; only after making these rites of passage could a person accede, finally, to full, adult genitality (the genital stage). Freud thought that neurotics had stalled at one of these earlier stages, where their libidos were prematurely dammed up and spilled over not only into symptoms and perversions but also into negative character traits. In his 1908 essay on the anal character, for example, Freud observed that many of his patients who were unconsciously fixated on the anal stage displayed traits such as orderliness, parsimoniousness, and obstinacy.
Ernest Jones and Karl Abraham built on Freud’s observations to elaborate on a further series of personality traits for the oral, anal, phallic, and genital types. It was hoped that the analyst, armed with a list of character types, would immediately be able to recognize and understand defective developments, and therefore correct them more quickly.30 Reich’s first book, The Impulsive Character: A Psychoanalytic Study of Ego Pathology (1925), based on his treatment of patients at the Ambulatorium with especially troubled backgrounds, represented his attempt to contribute to this trend toward characterology; in the book he argued for a “single, systematic theory of character…a psychic embryology.”31
Because Freud saw psychosexual development as a linear progression culminating in full genitality, it was inevitable that the genital character was destined to display virtues lacking in the other stages. As the historian of psychoanalysis Nathan G. Hale has observed, the genital character was held up by many analysts as the “norm of human attainment.” The individual who had conquered all other stages to achieve the primacy of the genital phase was able to blend the most useful features of these earlier stages in a harmony of traits; from the oral stage, Abraham wrote of this ideal type, the genital character had retained “forward-pushing energy; from the anal stage, endurance and perseverance; from sadistic sources [which Freud traced to both the oral and anal phases] the necessary power to carry on the struggle for existence.”32
Reich, like most analysts, came to assert that establishing genital primacy was the only goal of therapy, but he equated this achievement with orgasm (of which his ex-patient, the impotent waiter, remained deprived). He asserted that genital disturbance was the most important symptom of neurosis. “It is quite striking,” Reich wrote in his essay “On Genitality” (1924), that “amongst the twenty-eight male and fourteen female neurotics I have treated, there was not one who did not manifest symptoms of impotence, frigidity, or sexual abstinence. A survey of several other analysts revealed similar findings.”33 Reich thought a wave of genital excitement in orgasm would rupture the stagnant dams of repression he saw in these patients and shortcut the long, slow process of analysis by leading them more quickly to full genitality.
Reich would encourage, indeed teach, his patients to have regular orgasms. When he instructed one of his patients, an elderly woman suffering from a nervous tic that interfered with her breathing, how to masturbate, Reich wrote that her symptom suddenly subsided. He worked with another young man to dissolve the guilt he felt over masturbation, the cause, Reich thought, of his patient’s headaches, nausea, back pains, and absentmindedness. These symptoms apparently cleared up when he discovered complete gratification in the act. (“Guidance of masturbational practices during treatment,” Reich concluded in a 1922 study of several of the eccentric sexual habits of the Ambulatorium’s patients, is “an essential and active therapeutic tool in the hands of the analyst.”)34
Reich persuaded one woman who was in a sexless marriage to have an affair with a young suitor; he seemed to encourage, or at least condone, others’ sleeping with prostitutes. Reich came increasingly to believe that enabling the patient to achieve orgasm was the measure of successful therapy. The process of analysis had troubled Reich because it had no clearly defined goal, and now he felt he’d found the means to the end of resolving neurosis in the orgasm.
Though there was considerable resistance to this theory from other analysts, Reich’s ideas would later position him at the forefront of the group of younger psychoanalysts. As the second generation of therapists sought to redefine the relationship between the erotic demands of an increasingly liberated youth and the repressive moral pressures that constrained them, Reich’s theory of the orgasm became the defining metaphor for their sexual revolt.
Inducing orgasm to treat hysteria was an ancient cure that went back to the classical Greeks, who thought that an orgasm might reposition the wandering womb from which hysteria took its name. As the historian Rachel Maines has shown in The Technology of Orgasm, “massage to orgasm of female patients was a staple of medical practice among some (but certainly not all) Western physicians from the time of Hippocrates until the 1920s.”35 The treatment, aimed at relieving congestion of the womb, was not without its moral risks; one turn-of-the-century doctor claimed that the task “should be entrusted to those who have ‘clean hands and a pure heart.’”36
In 1878 an electro-mechanical vibrator was used at Paris’s Salpêtrière Hospital to treat female hysterics, which introduced a further degree of clinical distance. That year a male doctor at the institution, Desiré Magloire Bourneville, published a three-volume photographic atlas depicting patients suffering from hysteria and
epilepsy that contained photos of women in the throes of mechanically stimulated orgasms. One eighteen-year-old patient referred to as “Th.” in Bourneville’s notes is reported to have cried “Oue! Oue!” as she approached climax, before throwing back her head and rocking her torso violently: “Then her body curves into an arc and holds this position for several seconds,” Bourneville wrote. “One then observes some slight movements of the pelvis…she raises herself, lies flat again, utters cries of pleasure, laughs, makes several lubricious movements and sinks down on to the vulva and right hip.”37 During her ecstasy Bourneville made detailed physiological notes from his vantage point as the machine’s operator: “La vulve est humide…La secretion vaginale est très abondante.”38 From the 1880s, the vibrator became a widely used tool, an essential piece of equipment in many doctors’ offices and sanatoriums, which gave speed and efficiency to a previously manual process. By the 1920s the device began to appear in the first pornographic films, which discredited it somewhat as a purely medical tool.
Freud would have been aware of Bourneville’s innovations when he interned at the Salpêtrière in 1885, as well as the other vibrating helmets and shaking chairs Charcot used to calm his hysterical patients. At one evening reception he attended at the hospital, Freud heard Charcot excitedly telling a colleague that hysteria always had a genital origin (“C’est toujours la chose génitale, toujours! Toujours! Toujours!”), explaining that all neuroses could be traced back to the “marriage bed” (as in the particular case under discussion, which involved an impotent husband).39 Freud wrote that he was “almost paralyzed with astonishment” at the time, the idea was so shocking, and he soon repressed Charcot’s never-published observation.40
When Freud returned to Vienna and established his private practice, he was reminded of Charcot’s controversial remark when his colleague Rudolf Chrobak referred a hysterical patient to him who was still a virgin despite having been married for eighteen years. Chrobak commented sarcastically, “We know only too well what the only prescription is for such cases, but we can’t prescribe it. It is: ‘Penis normalis. Dosim repetatur!’”41 At his clinic Freud employed hydrotherapy, electrotherapy, massage, and the Weir-Mitchell rest cure before abandoning these methods in favor of hypnosis. Rachel Maines wonders whether Freud, who claimed a certain expertise when he distinguished the vaginal from the clitoral orgasm (he considered the latter immature and inferior, to the annoyance of many 1960s feminists), ever operated as a “gynaecological masseur.” In Studies on Hysteria Freud wrote of the case of “Elisabeth von R.,” who had an orgasm when he “pressed or pinched” her legs, supposedly to test her response to pain.42
In a letter dated 1893 to his friend and mentor Wilhelm Fliess, Freud noted that nervous illness was frequently a consequence of an abnormal sex life and speculated about a possible cure for neuroses along free-love lines: “The only alternative would be free sexual intercourse between young men and women. Otherwise the alternatives are masturbation, neurasthenia…In the absence of such a solution society seems doomed to fall victim to incurable neuroses.”43 In his first decade of practicing psychoanalysis, Freud continued to maintain that neuroses were caused by enforced abstinence and coitus interruptus (a belief his diaphragm-fitting colleague, Isidor Sadger, evidently still held in the early twenties), which forced the libido to find alternative outlets in hysterical and neurotic behavior. In 1905, even after his relationship with Fliess had disintegrated, Freud continued to maintain that “in a normal vita sexualis no neurosis is possible.”44
Some of Freud’s colleagues, one of them the Austrian doctor Otto Gross, took these ideas to extremes, encouraging people to throw off what he considered to be the out-of-date moral prejudices that caused sickness: “Repress nothing!”45 Freud held Gross in high esteem, and thought he had the most original mind among his followers (according to Ernest Jones, who befriended Gross and considered their conversations to have constituted his first analysis, Gross was “the nearest approach to a romantic genius I ever met”), though Gross’s morphine and cocaine addiction made him a paranoid and a particularly wild analyst.46 In September 1907, Jung wrote to Freud of Gross’s radical ideas: “Dr. Gross tells me that he puts a quick stop to the transference by turning people into sexual immoralists. He says the transference to the analyst and its persistent fixation are mere monogamy symbols and as such symptomatic of repression. The truly healthy state for the neurotic is sexual immorality.”47 (Jung would treat Gross in Switzerland the following year for his drug addiction.)
In his paper “‘Civilized Sexual Morality and Modern Nervousness,’” published in 1908, Freud criticized the puritanical sexual mores that so often lead to neurosis and sadism, such as enforced monogamy and abstinence. Freud implied that a lack of sex was as degenerative to the species as inbreeding, and that further repressions of the sexual instincts might endanger the very existence of the human race. “I have not gained the impression,” Freud wrote, “that sexual abstinence helps to shape energetic, self-reliant men of action, nor original thinkers, bold pioneers and reformers; far more often it produces ‘good’ weaklings who later become lost in the crowd.”48 Freud posed the question: Is civilized sexual morality worth the sacrifice it imposes upon us? It was this fundamental question that Reich took up.
Reich thought he noticed the same sex-deprived weakness in his patients and, like Gross, celebrated sexual immorality as a cure. Reich followed Freud in believing that a core of dammed-up sexual energy acted as a reservoir for neuroses to sprout up. Adopting Freud’s hydraulic notion of the libido, he came to believe that a healthy sex life, full of orgasms—at least one a day if possible—would deprive these symptoms of the sustenance that they needed to grow by maintaining a healthy flow of sexual energy. (The writer Arthur Schnitzler, a caddish bachelor, former doctor, and a friend of Freud’s, kept a diary in which he recorded his orgasms, sometimes as many as eight a night, and drew up monthly totals subdivided by each mistress; he omitted tallying theirs.)
However, by the time Reich first visited him at Berggasse 19, Freud was moving away from such a sexually radical solution to mental health problems. In 1920, the year after Reich met him, Freud published Beyond the Pleasure Principle, which set Thanatos against Eros, the death drive against the sex drive, and marked a decisive shift away from his early thinking about repression. In that essay he argued that the drive for gratification, love, and life is always overshadowed by a self-destructive urge toward aggression and death.
Freud’s theory of anxiety evolved in parallel with this shift in his thinking. In his Introductory Lectures on Psychoanalysis (1917), Freud regarded anxiety, like hysteria, as an outgrowth of sexual repression, caused by unsatisfied libido, which—like wine turning to vinegar—seeks discharge in palpitations and breathlessness, dizziness and nausea. However, Freud now asserted that anxiety was a cause rather than an effect of repression: “It was not the repression that created the anxiety,” Freud wrote in Inhibitions, Symptoms and Anxiety (1926). “The anxiety was there earlier; it was the anxiety that made the repression.”49 Freud now suggested that repression wasn’t something that could be thrown off, as Reich would maintain, but was an intrinsic part of the human condition. To Freud, misery came from within; to Reich, it was imposed from without.
Reich claimed to have kept his discovery of the therapeutic powers of the orgasm to himself at first, because he thought that the world of psychoanalysis wasn’t yet ready for his theory: “The actual goal of therapy,” he recalled, “that of making the patient capable of orgasm, was not mentioned in the first years of the seminar. I avoided the subject instinctively.”50 In fact, Reich did air his theory quite early, at a meeting of the Vienna Psychoanalytic Society in November 1923, where it met with a frosty reception:
During my presentation, I became aware of a growing chilliness in the mood of the meeting. I was a good speaker and had always been listened to attentively. When I finished, an icy stillness hung over the room. Following a break, the discussion b
egan. My contention that the genital disturbance was an important, perhaps the most important symptom of the neurosis was said to be erroneous…Two analysts literally asserted that they knew any number of female patients who had a “completely healthy sex life.” They appeared to me to be more excited than was in keeping with their usual scientific reserve.51
The only member of the older generation to support him on that occasion (and only privately) was his boss at the Ambulatorium, Eduard Hitschmann, who told him afterward, “You hit the nail on the head!”52 Reich had evolved his ideas under Hitschmann’s supervision. Hitschmann, the expert in curing frigidity and impotence, was famous for treating sexual disturbances with a calm practicality; when the analyst Fritz Perls, who later went back into analysis with Reich to be treated for impotence, lay on Hitschmann’s couch and told him of the anxieties he had about his manhood, Hitschmann said, “Well, take out your penis. Let’s have a look at the thing.”53 According to the Minutes of the Vienna Psychoanalytic Society, Hitschmann “always advocated searching for ‘organic factors’ as a background of the neurosis,” which is just what Reich thought he’d discovered in the orgasm.54
Encouraged by Hitschmann, and desperate to prove the universality of his theory, Reich began to collect case histories that same month, grilling patients at the Ambulatorium about the minutiae of their sex lives. In 1924 he was promoted to assistant director, and could incorporate in his study information from the weekly written summaries his colleagues were required to submit to him (patients were assigned case numbers to protect their privacy); statistics were collected on 410 individuals, 72 of them Reich’s own patients.
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